126 Dihydrocodeine
long enough. Drug maintenance programs, in which addicts are weaned off
one drug of abuse and switched to one that treatment authorities consider
preferable, have used dihydrocodeine to switch addicts fromheroinand other
opiates. Those programs have also usedmethadoneand dihydrocodeine to
substitute for each other: Methadone addicts have been switched to dihydro-
codeine and vice versa, substitution indicating that drug abusers find the two
substances to be similar. Body chemistry converts dihydrocodeine into dihy-
dromorphine, a Schedule I controlled substance. Although an illicit market
exists for dihydrocodeine, some physicians believe illegal diversion of pre-
scriptions is discouraged by the nature of the drug: Dissolving oral tablets for
injection is difficult, and intravenous injection typically produces discontent-
ment rather than euphoria.
Drug interactions.The drug may boost actions of the anti–blood clotting
medicine warfarin.
Cancer.Not enough scientific information to report.
Pregnancy.Many pregnant women have used dihydrocodeine with no ap-
parent harm to fetal development. Nonetheless, the compound is not recom-
mended during pregnancy, and excessive quantities can produce an infant
who is dependent at birth. Although researchers are uncertain if the substance
passes into breast milk, they believe the amount would be too small to no-
ticeably affect nursing infants.
Additional scientific information may be found in:Frame, J.W., et al. “A Comparison of Ibuprofen and Dihydrocodeine in Relieving Pain
Following Wisdom Teeth Removal.”British Dental Journal166 (1989): 121–24.
Johnson, M.A., A.A. Woodcock, and D.M. Geddes. “Dihydrocodeine for Breathlessness
in Pink Puffers.”British Medical Journal286 (1983): 675–77.
Marks, P., H. Ashraf, and T.R. Root. “Drug Dependence Caused by Dihydihydroco-
deine.”British Medical Journal1 (1978): 1594.
Palmer, R.N., et al. “Incidence of Unwanted Effects of Dihydrocodeine Bitartrate in
Healthy Volunteers.”Lancet17 (1966): 620–21.
Takaoka, K., and T. Takata. “ ‘Alice in Wonderland’ Syndrome and Lilliputian Hallu-
cinations in a Patient with a Substance-Related Disorder.”Psychopathology 32
(1999): 47–49.
Wotherspoon, H.A., G.N. Kenny, and C.S. McArdle. “Analgesic Efficacy of Controlled-
Release Dihydrocodeine. A Comparison of 60, 90 and 120 Mg Tablets in Cold-
Induced Pain.”Anaesthesia46 (1991): 915–17.